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1.
Annu Rev Virol ; 7(1): 475-494, 2020 09 29.
Article in English | MEDLINE | ID: covidwho-865856

ABSTRACT

The conduct of clinical trials during the West Africa Ebola outbreak in 2014 highlighted many ethical challenges. How these challenges were addressed, what clinical studies were conducted during that outbreak, and the lessons learned for dealing with future outbreaks were the subject of a National Academy of Medicine committee report titled Integrating Clinical Research into Epidemic Response: The Ebola Experience. This report suggested improvements for research during subsequent emerging or re-emerging outbreaks and is summarized in this review. We also discuss the current Ebola outbreak in the Democratic Republic of the Congo and highlight how the dialogue has changed and how successful clinical trials have been implemented. We conclude with a description of productive efforts to include pregnant women and children in therapeutic and vaccine trials during outbreaks that are currently ongoing.


Subject(s)
Biomedical Research/ethics , Clinical Trials as Topic/ethics , Disease Outbreaks , Ebolavirus/pathogenicity , Hemorrhagic Fever, Ebola/epidemiology , Patient Selection/ethics , Adult , Africa, Western/epidemiology , Antiviral Agents/therapeutic use , Biomedical Research/organization & administration , Child , Clinical Trials as Topic/organization & administration , Ebola Vaccines/administration & dosage , Female , Hemorrhagic Fever, Ebola/immunology , Hemorrhagic Fever, Ebola/mortality , Hemorrhagic Fever, Ebola/prevention & control , Humans , International Cooperation , Male , Pregnancy , Survival Analysis
2.
Sci Rep ; 10(1): 16496, 2020 10 05.
Article in English | MEDLINE | ID: covidwho-834909

ABSTRACT

This study aimed to analyze aspartate aminotransferase (AST) to alanine aminotransferase (ALT) ratio in COVID-19 patients. After exclusion, 567 inpatients were included in this study and separated into two groups according to their AST/ALT ratio on admission. Death was regarded as poor prognosis in this study. Of 567 patients, 200 (35.3%) had AST/ALT ≥ 1.38. Of the 200 patients, older age (median age 60 years), myalgia (64 [32%] cases), fatigue (91 [45.5%] cases), some comorbidities and outcomes were significantly different from patients with AST/ALT < 1.38. They also had worse chest computed tomography (CT) findings, laboratory results and severity scores. Levels of platelet count (OR 0.995, 95% CI [0.992-0.998]) and hemoglobin (OR 0.984, 95% CI [0.972-0.995]) were independently associated with AST/ALT ≥ 1.38 on admission. Furthermore, a high AST/ALT ratio on admission was an independent risk factor for poor prognosis (OR 99.9, 95% CI [2.1-4280.5]). In subsequent monitoring, both survivors and non-survivors showed decreased AST/ALT ratio during hospitalization. In conclusion, high AST/ALT ratio might be the indication of worse status and outcomes in COVID-19 patients.


Subject(s)
Alanine Transaminase/blood , Aspartate Aminotransferases/blood , Coronavirus Infections/blood , Pneumonia, Viral/blood , Adult , Age Factors , Aged , Biomarkers/blood , Comorbidity , Coronavirus Infections/epidemiology , Coronavirus Infections/pathology , Fatigue/epidemiology , Female , Hemoglobins/analysis , Humans , Male , Middle Aged , Myalgia/epidemiology , Pandemics , Patient Admission/statistics & numerical data , Platelet Count , Pneumonia, Viral/epidemiology , Pneumonia, Viral/pathology , Survival Analysis
3.
BMJ Open ; 10(9): e040569, 2020 09 29.
Article in English | MEDLINE | ID: covidwho-809101

ABSTRACT

INTRODUCTION: This protocol describes an observational study which set out to assess whether frailty and/or multimorbidity correlates with short-term and medium-term outcomes in patients diagnosed with COVID-19 in a European, multicentre setting. METHODS AND ANALYSIS: Over a 3-month period we aim to recruit a minimum of 500 patients across 10 hospital sites, collecting baseline data including: patient demographics; presence of comorbidities; relevant blood tests on admission; prescription of ACE inhibitors/angiotensin receptor blockers/non-steroidal anti-inflammatory drugs/immunosuppressants; smoking status; Clinical Frailty Score (CFS); length of hospital stay; mortality and readmission. All patients receiving inpatient hospital care >18 years who receive a diagnosis of COVID-19 are eligible for inclusion. Long-term follow-up at 6 and 12 months is planned. This will assess frailty, quality of life and medical complications.Our primary analysis will be short-term and long-term mortality by CFS, adjusted for age (18-64, 65-80 and >80) and gender. We will carry out a secondary analysis of the primary outcome by including additional clinical mediators which are determined statistically important using a likelihood ratio test. All analyses will be presented as crude and adjusted HR and OR with associated 95% CIs and p values. ETHICS AND DISSEMINATION: This study has been registered, reviewed and approved by the following: Health Research Authority (20/HRA1898); Ethics Committee of Hospital Policlinico Modena, Italy (369/2020/OSS/AOUMO); Health and Care Research Permissions Service, Wales; and NHS Research Scotland Permissions Co-ordinating Centre, Scotland. All participating units obtained approval from their local Research and Development department consistent with the guidance from their relevant national organisation.Data will be reported as a whole cohort. This project will be submitted for presentation at a national or international surgical and geriatric conference. Manuscript(s) will be prepared following the close of the project.


Subject(s)
Coronavirus Infections , Frail Elderly , Frailty , Multimorbidity , Pandemics , Pneumonia, Viral , Public Health/methods , Quality of Life , Adult , Aged , Betacoronavirus/isolation & purification , Coronavirus Infections/diagnosis , Coronavirus Infections/mortality , Coronavirus Infections/therapy , Correlation of Data , Europe/epidemiology , Female , Frail Elderly/psychology , Frail Elderly/statistics & numerical data , Frailty/diagnosis , Frailty/epidemiology , Geriatric Assessment/methods , Hospitalization/statistics & numerical data , Humans , Male , Multicenter Studies as Topic , Observational Studies as Topic , Pneumonia, Viral/diagnosis , Pneumonia, Viral/mortality , Pneumonia, Viral/therapy , Survival Analysis
4.
Biol Blood Marrow Transplant ; 26(7): e161-e166, 2020 07.
Article in English | MEDLINE | ID: covidwho-799190

ABSTRACT

With the COVID-19 pandemic and the ensuing barriers to the collection and transport of donor cells, it is often necessary to collect and cryopreserve grafts before initiation of transplantation conditioning. The effect on transplantation outcomes in nonmalignant disease is unknown. This analysis examined the effect of cryopreservation of related and unrelated donor grafts for transplantation for severe aplastic anemia in the United States during 2013 to 2019. Included are 52 recipients of cryopreserved grafts who were matched for age, donor type, and graft type to 194 recipients who received noncryopreserved grafts. Marginal Cox regression models were built to study the effect of cryopreservation and other risk factors associated with outcomes. We recorded higher 1-year rates of graft failure (hazard ratio [HR], 2.26; 95% confidence interval, 1.17 to 4.35; P = .01) and of 1-year overall mortality (HR, 3.13; 95% CI, 1.60 to 6.11; P = .0008) after transplantation of cryopreserved compared with noncryopreserved grafts, with adjustment for sex, performance score, comorbidity, cytomegalovirus serostatus, and ABO blood group match. The incidence of acute and chronic graft-versus-host disease did not differ between the 2 groups. Adjusted probabilities of 1-year survival were 73% (95% CI, 60% to 84%) in the cryopreserved graft group and 91% (95% CI, 86% to 94%) in the noncryopreserved graft group. These data support the use of noncryopreserved grafts whenever possible in patients with severe aplastic anemia.


Subject(s)
Anemia, Aplastic/therapy , Bone Marrow Transplantation/methods , Coronavirus Infections/epidemiology , Cryopreservation/methods , Graft Rejection/pathology , Graft vs Host Disease/pathology , Peripheral Blood Stem Cell Transplantation/methods , Pneumonia, Viral/epidemiology , Acute Disease , Adolescent , Adult , Aged , Anemia, Aplastic/immunology , Anemia, Aplastic/mortality , Anemia, Aplastic/pathology , Child , Child, Preschool , Female , Graft Rejection/immunology , Graft Rejection/mortality , Graft vs Host Disease/immunology , Graft vs Host Disease/mortality , Histocompatibility Testing , Humans , Male , Middle Aged , Pandemics , Retrospective Studies , Siblings , Survival Analysis , Transplantation Conditioning/methods , United States/epidemiology , Unrelated Donors
6.
J Int Med Res ; 48(9): 300060520956834, 2020 Sep.
Article in English | MEDLINE | ID: covidwho-792235

ABSTRACT

PURPOSE: To investigate associations between the clinical characteristics and incubation periods of patients infected with coronavirus disease 2019 (COVID-19) in Wuhan, China. METHODS: Complete clinical and epidemiological data from 149 patients with COVID-19 at a hospital in Hunan Province, China, were collected and retrospectively analyzed. RESULTS: Analysis of the distribution and receiver operator characteristic curve of incubation periods showed that 7 days was the optimal cut-off value to assess differences in disease severity between groups. Patients with shorter (≤7 days) incubation periods (n = 79) had more severe disease, longer durations of hospitalization, longer times from symptom onset to discharge, more abnormal laboratory findings, and more severe radiological findings than patients with longer (>7 days) incubation periods. Regression and correlation analyses also showed that a shorter incubation period was associated with longer times from symptom onset to discharge. CONCLUSION: The associations between the incubation periods and clinical characteristics of COVID-19 patients suggest that the incubation period may be a useful marker of disease severity and prognosis.


Subject(s)
Betacoronavirus/pathogenicity , Coronavirus Infections/diagnosis , Coronavirus Infections/physiopathology , Infectious Disease Incubation Period , Pneumonia, Viral/diagnosis , Pneumonia, Viral/physiopathology , Adolescent , Adult , Aged , Biomarkers/analysis , Coronavirus Infections/mortality , Coronavirus Infections/virology , Female , Hospitalization/statistics & numerical data , Humans , Logistic Models , Male , Middle Aged , Pandemics , Patient Discharge/statistics & numerical data , Pneumonia, Viral/mortality , Pneumonia, Viral/virology , Prognosis , ROC Curve , Retrospective Studies , Severity of Illness Index , Survival Analysis
7.
J Int Med Res ; 48(9): 300060520955037, 2020 Sep.
Article in English | MEDLINE | ID: covidwho-788436

ABSTRACT

BACKGROUND: The roles of inflammation and hypercoagulation in predicting outcomes of coronavirus disease 2019 (COVID-19) are unclear. METHODS: Adult patients diagnosed with COVID-19 from 28 January 2020 to 4 March 2020 in Tongji Hospital, Wuhan were recruited. Data on related parameters were collected. Univariate analysis and multivariable binary logistic regression were used to explore predictors of critical illness and mortality. RESULTS: In total, 199 and 44 patients were enrolled in the training and testing sets, respectively. Elevated ferritin, tumor necrosis factor-α and D-dimer and decreased albumin concentration were associated with disease severity. Older age, elevated ferritin and elevated interleukin-6 were associated with 28-day mortality. The FAD-85 score, defined as age + 0.01 * ferritin +D-dimer, was used to predict risk of mortality. The sensitivity, specificity and accuracy of FAD-85 were 86.4%, 81.8% and 86.4%, respectively. A nomogram was established using age, ferritin and D-dimer to predict the risk of 28-day mortality. CONCLUSIONS: Thrombo-inflammatory parameters provide key information on the severity and prognosis of COVID-19 and can be used as references for clinical treatment to correct inflammatory and coagulation abnormalities.


Subject(s)
Betacoronavirus/pathogenicity , Coronavirus Infections/mortality , Disseminated Intravascular Coagulation/mortality , Pneumonia, Viral/mortality , Thrombosis/mortality , Adult , Aged , Biomarkers/blood , Coronavirus Infections/complications , Coronavirus Infections/diagnosis , Coronavirus Infections/virology , Disseminated Intravascular Coagulation/complications , Disseminated Intravascular Coagulation/diagnosis , Disseminated Intravascular Coagulation/virology , Female , Ferritins/blood , Fibrin Fibrinogen Degradation Products/metabolism , Humans , Interleukin-6/blood , Logistic Models , Male , Middle Aged , Pandemics , Pneumonia, Viral/complications , Pneumonia, Viral/diagnosis , Pneumonia, Viral/virology , Prognosis , Research Design , Retrospective Studies , Serum Albumin/metabolism , Severity of Illness Index , Survival Analysis , Thrombosis/complications , Thrombosis/diagnosis , Thrombosis/virology , Tumor Necrosis Factor-alpha/blood
8.
Virus Res ; 286: 198057, 2020 09.
Article in English | MEDLINE | ID: covidwho-773200

ABSTRACT

The fight against the novel coronavirus pneumonia (namely COVID-19) that seriously harms human health is a common task for all mankind. Currently, development of drugs against the novel coronavirus (namely SARS-CoV-2) is quite urgent. Chinese medical workers and scientific researchers have found some drugs to play potential therapeutic effects on COVID-19 at the cellular level or in preliminary clinical trials. However, more fundamental studies and large sample clinical trials need to be done to ensure the efficacy and safety of these drugs. The adoption of these drugs without further testing must be careful. The relevant articles, news, and government reports published on the official and Preprint websites, PubMed and China National Knowledge Infrastructure (CNKI) databases from December 2019 to April 2020 were searched and manually filtered. The general pharmacological characteristics, indications, adverse reactions, general usage, and especially current status of the treatment of COVID-19 of those potentially effective drugs, including chemical drugs, traditional Chinese medicines (TCMs), and biological products in China were summarized in this review to guide reasonable medication and the development of specific drugs for the treatment of COVID-19.


Subject(s)
Antiviral Agents/therapeutic use , Betacoronavirus/drug effects , Coronavirus Infections/drug therapy , Coronavirus Infections/epidemiology , Drugs, Chinese Herbal/therapeutic use , Pandemics , Pneumonia, Viral/drug therapy , Pneumonia, Viral/epidemiology , Adenosine Monophosphate/analogs & derivatives , Adenosine Monophosphate/therapeutic use , Alanine/analogs & derivatives , Alanine/therapeutic use , Amides/therapeutic use , Betacoronavirus/immunology , China/epidemiology , Chloroquine/therapeutic use , Coronavirus Infections/mortality , Coronavirus Infections/virology , Drug Combinations , Humans , Indoles/therapeutic use , Interferons/therapeutic use , Lopinavir/therapeutic use , Lung/drug effects , Lung/pathology , Lung/virology , Pneumonia, Viral/mortality , Pneumonia, Viral/virology , Pyrazines/therapeutic use , Ribavirin/therapeutic use , Ritonavir/therapeutic use , Survival Analysis
10.
Am J Mens Health ; 14(5): 1557988320954021, 2020.
Article in English | MEDLINE | ID: covidwho-772042

ABSTRACT

Coronaviruses are single-stranded ribonucleic acid viruses that can cause illnesses in humans ranging from the common cold to severe respiratory disease and even death.In March 2020, the World Health Organization declared the 2019 novel coronavirus disease (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) as the first pandemic. Compared to women, most countries with available data report that men with COVID-19 have greater disease severity and higher mortality. Lab and animal data indicate that men respond differently to the SARS-CoV-2 infection, offering possible explanations for the epidemiologic observations. The plausible theories underlying these observations include sex-related differences in angiotensin-converting enzyme 2 receptors, immune function, hormones, habits, and coinfection rates.In this review we examine these factors and explore the rationale as to how each may impact COVID-19. Understanding why men are more likely to experience severe disease can help in developing effective treatments, public health policies, and targeted strategies such as early recognition and aggressive testing in subgroups.


Subject(s)
Coronavirus Infections/epidemiology , Pandemics/statistics & numerical data , Peptidyl-Dipeptidase A/metabolism , Pneumonia, Viral/epidemiology , Severe Acute Respiratory Syndrome/epidemiology , Biomarkers/metabolism , Female , Genetic Markers/physiology , Global Health , Humans , Male , Prevalence , Risk Assessment , Sex Factors , Survival Analysis , World Health Organization
11.
Am J Mens Health ; 14(5): 1557988320957545, 2020.
Article in English | MEDLINE | ID: covidwho-772041

ABSTRACT

While there is evidence of variations in the risk perceptions of COVID-19 and that they are linked to both engagement in health-protective behaviors and poor mental health outcomes, there has been a lack of attention to how individuals perceive the risk of COVID-19 relative to other infectious diseases. This paper examines the relative perceptions of the severity of COVID-19 and HIV among a sample of U.S. gay, bisexual, and other men who have sex with men (GBMSMs). The "Love and Sex in the Time of COVID-19" survey was conducted online from April 2020 to May 2020. GBMSMs were recruited through paid banner advertisements featured on social networking platforms, resulting in a sample size of 696. The analysis considers differences in responses to two scales: the Perceived Severity of HIV Infection and the Perceived Severity of COVID-19 Infection. Participants perceived greater seriousness for HIV infection (mean 46.67, range 17-65) than for COVID-19 infection (mean 38.81, range 13-62). Some items reflecting more proximal impacts of infection (anxiety, loss of sleep, and impact on employment) were similar for HIV and COVID-19. Those aged over 25 and those who perceived higher prevalence of COVID-19 in the United States or their state were more likely to report COVID-19 as more severe than HIV. There is a need to develop nuanced public health messages for GBMSMs that convey the ongoing simultaneous health threats of both HIV and COVID-19.


Subject(s)
Coronavirus Infections/epidemiology , Ethnic Groups/statistics & numerical data , HIV Infections/epidemiology , Homosexuality, Male/statistics & numerical data , Pneumonia, Viral/epidemiology , Risk-Taking , Adolescent , Adult , Aged , Bisexuality/statistics & numerical data , Cross-Sectional Studies , Female , Humans , Incidence , Internet , Male , Middle Aged , Pandemics , Risk Assessment , Severity of Illness Index , Sexual Behavior , Survival Analysis , United States/epidemiology , Young Adult
12.
Eur Cytokine Netw ; 31(2): 44-49, 2020 Jun 01.
Article in English | MEDLINE | ID: covidwho-771671

ABSTRACT

BACKGROUND: Evidence links COVID-19 severity to hyper-inflammation. Treatment with tocilizumab, a monoclonal antibody directed against the interleukin-6 (IL-6) receptor, was shown to lead to clinical improvement in patients with severe COVID-19. We, therefore, performed the present systematic review and meta-analysis to investigate whether the circulating levels of IL-6 is a reliable indicator of disease severity among patients affected with COVID-19. METHODS: A systematic search was conducted in PubMed, Scopus, Web of Science, and Google Scholar on April 19, 2020. RESULTS: Eleven studies provided data of IL-6 levels in patients with severe to critical COVID-19 (severe) and patients with mild to moderate COVID-19 (non-severe). The included studies were of moderate to high quality. The mean patients' age was 60.9 years, ranging from 45.2 to 76.7 years in the severe group and 46.8 years, ranging from 37.9 to 61 years, in the nonsevere group. Fifty-two percent were male in the severe group, as compared to 46% in the non-severe group. An overall random effects meta-analysis showed significantly higher serum levels of IL-6 in the severe group than in the non-severe group with a mean difference of +23.1 pg/mL (95% CI: 12.42-33.79) and the overall effect of 4.24 (P-value < 0.001). Meta-regressions showed that neither age nor sex significantly influenced the mean difference of IL-6 between the groups. CONCLUSIONS: Meta-analysis and meta-regression reveal a reliable relationship between IL-6 and COVID-19 severity, independent of age and sex. Future research is, however, required to assess the effect of BMI on the pattern of IL-6 production in patients with COVID-19. Also, there might be confounding factors that influence the relationship between IL-6 and COVID-19 severity and remain as yet unknown.


Subject(s)
Anti-Inflammatory Agents/therapeutic use , Antibodies, Monoclonal, Humanized/administration & dosage , Antiviral Agents/therapeutic use , Betacoronavirus/immunology , Coronavirus Infections/drug therapy , Cytokine Release Syndrome/drug therapy , Interleukin-6/antagonists & inhibitors , Pneumonia, Viral/drug therapy , Aged , Betacoronavirus/pathogenicity , Coronavirus Infections/immunology , Coronavirus Infections/mortality , Coronavirus Infections/virology , Cytokine Release Syndrome/immunology , Cytokine Release Syndrome/mortality , Cytokine Release Syndrome/virology , Female , Gene Expression , Humans , Intensive Care Units , Interleukin-6/genetics , Interleukin-6/immunology , Male , Middle Aged , Pandemics , Pneumonia, Viral/immunology , Pneumonia, Viral/mortality , Pneumonia, Viral/virology , Receptors, Interleukin-6/genetics , Receptors, Interleukin-6/immunology , Severity of Illness Index , Survival Analysis , Treatment Outcome
14.
Int J Antimicrob Agents ; 56(4): 106143, 2020 Oct.
Article in English | MEDLINE | ID: covidwho-764714

ABSTRACT

As no specific pharmacological treatment has been validated for use in coronavirus disease 2019 (COVID-19), we aimed to assess the effectiveness of azithromycin (AZM) in these patients at a referral centre in Iran. An open-label, randomised controlled trial was conducted on patients with laboratory-confirmed COVID-19. A total of 55 patients in the control group receiving hydroxychloroquine (HCQ) and lopinavir/ritonavir (LPV/r) were compared with 56 patients in the case group who in addition to the same regimen also received AZM. Patients with prior cardiac disease were excluded from the study. Furthermore, patients from the case group were assessed for cardiac arrythmia risk based on the American College of Cardiology (ACC) risk assessment for use of AZM and HCQ. The main outcome measures were vital signs, SpO2 levels, duration of hospitalisation, need for and length of intensive care unit admission, mortality rate and results of 30-day follow-up after discharge. Initially, there was no significant difference between the general conditions and vital signs of the two groups. The SpO2 levels at discharge were significantly higher, the respiratory rate was lower and the duration of admission was shorter in the case group. There was no significant difference in the mortality rate between the two groups. Patients who received AZM in addition to HCQ and LPV/r had a better general condition. HCQ+AZM combination may be beneficial for individuals who are known to have a very low underlying risk for cardiac arrhythmia based on the ACC criteria.


Subject(s)
Anti-Infective Agents/therapeutic use , Azithromycin/therapeutic use , Betacoronavirus/drug effects , Coronavirus Infections/drug therapy , Hydroxychloroquine/therapeutic use , Lopinavir/therapeutic use , Pneumonia, Viral/drug therapy , Ritonavir/therapeutic use , Adult , Aged , Betacoronavirus/pathogenicity , C-Reactive Protein/metabolism , Coronavirus Infections/diagnostic imaging , Coronavirus Infections/mortality , Coronavirus Infections/pathology , Disease Progression , Drug Combinations , Female , Heart Rate/physiology , Humans , Intensive Care Units , Male , Middle Aged , Pandemics , Patient Safety , Pneumonia, Viral/diagnostic imaging , Pneumonia, Viral/mortality , Pneumonia, Viral/pathology , Prognosis , Respiratory Function Tests , Survival Analysis , T-Lymphocytes/pathology , T-Lymphocytes/virology , Tomography, X-Ray Computed , Treatment Outcome
15.
Undersea Hyperb Med ; 47(3): 405-413, 2020.
Article in English | MEDLINE | ID: covidwho-762605

ABSTRACT

Objective: Given the high mortality and prolonged duration of mechanical ventilation of COVID-19 patients, we evaluated the safety and efficacy of hyperbaric oxygen for COVID-19 patients with respiratory distress. Methods: This is a single-center clinical trial of COVID-19 patients at NYU Winthrop Hospital from March 31 to April 28, 2020. Patients in this trial received hyperbaric oxygen therapy at 2.0 atmospheres of pressure in monoplace hyperbaric chambers for 90 minutes daily for a maximum of five total treatments. Controls were identified using propensity score matching among COVID-19 patients admitted during the same time period. Using competing-risks survival regression, we analyzed our primary outcome of inpatient mortality and secondary outcome of mechanical ventilation. Results: We treated 20 COVID-19 patients with hyperbaric oxygen. Ages ranged from 30 to 79 years with an oxygen requirement ranging from 2 to 15 liters on hospital days 0 to 14. Of these 20 patients, two (10%) were intubated and died, and none remain hospitalized. Among 60 propensity-matched controls based on age, sex, body mass index, coronary artery disease, troponin, D-dimer, hospital day, and oxygen requirement, 18 (30%) were intubated, 13 (22%) have died, and three (5%) remain hospitalized (with one still requiring mechanical ventilation). Assuming no further deaths among controls, we estimate that the adjusted subdistribution hazard ratios were 0.37 for inpatient mortality (p=0.14) and 0.26 for mechanical ventilation (p=0.046). Conclusion: Though limited by its study design, our results demonstrate the safety of hyperbaric oxygen among COVID-19 patients and strongly suggests the need for a well-designed, multicenter randomized control trial.


Subject(s)
Betacoronavirus , Coronavirus Infections/therapy , Hyperbaric Oxygenation/methods , Pneumonia, Viral/therapy , Propensity Score , Respiratory Distress Syndrome, Adult/therapy , Adult , Aged , Atmospheric Pressure , Case-Control Studies , Coronavirus Infections/complications , Coronavirus Infections/mortality , Female , Humans , Hyperbaric Oxygenation/adverse effects , Male , Middle Aged , Pandemics , Pneumonia, Viral/complications , Pneumonia, Viral/mortality , Respiration, Artificial/mortality , Respiratory Distress Syndrome, Adult/etiology , Respiratory Distress Syndrome, Adult/mortality , Risk Factors , Safety , Survival Analysis , Time Factors , Treatment Outcome
18.
Lakartidningen ; 1172020 06 26.
Article in Swedish | MEDLINE | ID: covidwho-618554

ABSTRACT

A large proportion of deaths worldwide have occurred among elderly living in nursing homes. Sweden is no exception with a comparable proportion making up around half of all deaths. The elderly, frail individuals living in nursing homes are among the most vulnerable and with the highest risk to die of covid-19. In spite of that we see almost two-thirds of the infected are still alive with a majority recovering fully after receiving treatment at the nursing home. Of 8 057 residents living in nursing homes in Stockholm, 1 464 (18 %) individuals have so far been diagnosed  with covid-19 and 532 have died (6 % of all residents). Importantly, this means that a great majority of the residents are still alive including almost two-thirds (932/1 464) of the infected individuals.


Subject(s)
Coronavirus Infections , Frail Elderly , Nursing Homes , Pandemics , Pneumonia, Viral , Aged , Betacoronavirus , Coronavirus Infections/mortality , Humans , Pneumonia, Viral/mortality , Survival Analysis , Sweden/epidemiology
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